Written by Natalie Chung-Sayers, Sunnybrook's Communications Advisor for the Holland Musculoskeletal Program and the St. John's Rehab Program.
Weighing the pros and cons of group physiotherapy vs. one-on-one physiotherapy, after knee replacement surgery? Read on.
When Linda Veres, Ross Winter and Robert Morassutti happened to sign up for the same physiotherapy class, little did they know the difference group therapy would make.
In fact, studies show that patients who participate in group-based physiotherapy after joint replacement surgery achieve statistically and clinically important improvements in mobility and function, and with similar satisfaction levels as patients who receive one-on-one therapy at home.
"In that group setting, they connected through their experiences of getting through surgery, and a common goal to get moving well again," says Suzanne Denis, advanced practice physiotherapist, Holland Musculoskeletal Program who remembers Linda, Ross and Robert called themselves 'the knee people'. They had knee replacement surgery at Sunnybrook's Holland Centre then returned to join one of the group physiotherapy classes led by physiotherapist Mark Anunciacion.
Even though classes have ended, Linda, Ross and Robert continue to exercise together twice a week, motivating and supporting each other.
Beyond the clinical evidence, here are their reasons why getting together to exercise works:
Camaraderie – social + exercise: Ross says, "Doing physio alongside Linda and Robert who had a similar post-op (post-surgery) sensibility, allowed us to share with each other, experiences, knowledge, advice."
Context – motivate yourself, but know your limits! "Doing therapy with others helps give you context. Everyone is different, even though we all had the same surgery," says Robert. "And in some ways, it helped to 'normalize' things. We would ask each other: are you still using your cane? Being together gave you permission to either still be using the cane. Or not."
Commitment: "Sometimes, I'd be thinking to myself: I'd rather not do this [the exercises]," says Robert, "but as a group, we had made a commitment. To be there for each other." "And keep ourselves motivated," adds Linda.
Commiserate, but with consideration: "Misery loves company and it's better to share the pain than to suffer alone," says Ross. "Group physio gave everyone the occasion to express frustration about their lack of progress, or the discomfort. But temper those occasional complaints, with humour," says Linda. She recalls the generosity of the volunteers who would get ice for class participants. One particular day, she was feeling quite low and as the volunteer arrived with the ice, she joked, "Do you have gin with that?"
And because knee replacement is a 'big deal' even if some say it isn't, Linda, Ross and Robert also offer words of encouragement:
- Connect with friends and family: "As you prepare for surgery, think about what you will need, after surgery. It's hard to ask for help, but do! And ask for specific help!" "Until you know the 'new' you, you need someone there, to help you."
- Careful: "Pace yourself, for yourself, and DO NOT fall!"
- Consistency: "You have to keep at it [exercise]! Keep moving! Stretching and strengthening."
- Continuum: "Keep up the momentum even after 'formal' physio."
- Celebrate! "Everyone has their markers — milestones of progress, success, recovery." "Celebrate being closer to what you used to do – getting on a streetcar, being able to put the rugs down again at home, driving a car, taking the bus to go to a movie with a friend..."
Read more healthy living advice from Sunnybrook experts at health.sunnybrook.ca
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